Evaluation of the application of rhino-septal splints in endoscopic transsphenoidal skull base surgery

Schlüter, A; Ahmadipour, Yahya; Vogelsang, Trutz; Kreitschmann-Andermahr, Ilonka; Kleist, Bernadette; Weller, P; Holtmann, L; Mattheis, Stefan; Lang, Stephan; Bergmann, Christoph; Mueller, Oliver

doi:10.1007/s00405-016-4179-y

Cited by 7 publications

(5 citation statements)

References 17 publications

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“…Two studies used the Sniffin’ Sticks test to assess olfactory outcomes after ESBS. Schluter et al aimed to evaluate the effect of rhino‐septal splints after ESBS on olfaction, and found no significant changes in postoperative olfaction in either group . Soyka et al explored monorhinal olfaction after raising an NSF during ESBS of the sella .…”

Section: Resultsmentioning

confidence: 99%

“…Schluter et al aimed to evaluate the effect of rhino-septal splints after ESBS on olfaction, and found no significant changes in postoperative olfaction in either group. 42 Soyka et al explored monorhinal olfaction after raising an NSF during ESBS of the sella. 43 There was a significant decrease in olfactory function observed on the flap donor side of the nose compared to the contralateral side.…”

Section: Qualitative Summarymentioning

confidence: 99%

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Olfactory outcomes after endoscopic skull base surgery: A systematic review and meta‐analysis

et al. 2019

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Objectives Determine the effect of endoscopic skull base surgery (ESBS) on long‐term olfactory outcomes after surgery. Methods An English‐language search was conducted using the Cochrane, MEDLINE, Scopus, and Embase databases from January 2000 to October 2017 for adult patients undergoing ESBS with subjective and objective olfaction outcomes. Two authors independently examined articles to identify those meeting inclusion criteria. Studies examining objective olfactory outcomes after ESBS were included in the meta‐analysis. A random‐effects meta‐analysis of patients undergoing sellar and parasellar ESBS was conducted to compare preoperative and postoperative olfactory outcomes using the University of Pennsylvania Smell Identification Test (UPSIT) and Cross‐Cultural Smell Identification Test (CCSIT). Results Among 339 eligible articles, 29 articles met inclusion criteria. Twenty‐five of these focused on sellar and parasellar tumors. Individual articles not meeting criteria for meta‐analysis were qualitatively reported. Meta‐analysis showed there was no difference in preoperative and postoperative olfactory function after sellar and parasellar ESBS based on the UPSIT (five studies, mean difference [MD] = −1.03; 95% CI: −3.98, 1.93; P = .50) and the CCIST (three studies, MD = −0.77; 95% CI: −3.03, 1.49; P = .50). A pooled overall meta‐analysis revealed similar results (eight studies, effect size = −0.30; 95% CI: −0.79, 0.18; P = .22). However, heterogeneity for all meta‐analyses was high (I2 > 95%, P < .01), suggesting significant variation in the included studies. Conclusions Based on published objective olfaction outcomes after sellar and parasellar ESBS, there was no significant difference between preoperative and postoperative olfaction. Further prospective studies using validated objective measures of olfaction are required to improve our understanding on this subject. Level of Evidence 2a Laryngoscope, 129:1998–2007, 2019

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Section: Resultsmentioning

confidence: 99%

Section: Qualitative Summarymentioning

confidence: 99%

Olfactory outcomes after endoscopic skull base surgery: A systematic review and meta‐analysis

et al. 2019

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“…None of the patients developed acute sinusitis, synechia, or needed further treatment, while especially synechia is a common side effect after endoscopic skull base surgery (ESBS). 19…”

Section: Resultsmentioning

confidence: 99%

First Use of a New Robotic Endoscope Guiding System in Endoscopic Orbital Decompression

et al. 2019

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Purpose: Over the last years, robot-assisted surgery gained in importance in head and neck surgery. In our study, we used a new robotic endoscope guiding system in patients undergoing endoscopic balanced orbital decompression. The aim of the study is to evaluate the feasibility and benefit of a robotic arm in endoscopic orbital surgery. Methods: The Medineering Robotic Endoscope Guiding System is a robotic arm designed for holding an endoscope during interventions. An endoscope equipped with a 4K camera was attached at the tip of the robotic arm and placed in the surgical field. The surgeon controlled the movements of the endoscope with foot pedal. Eight patients underwent balanced endoscopic orbital decompression showing typical symptoms of Graves’ orbitopathy preoperatively. Balanced decompression was performed via a combined approach transnasally and laterally via a small skin incision. Results: Attaching the endoscope to the robotic guiding system and placing it in the nasal cavity were relatively simple procedures. Setup time was less than 10 minutes. Tool motion and control using the foot pedal were comfortable and adequately precise. Movements of the attached endoscope inside the nose were feasible and allowed 2-hand surgery. The patients did not show any adverse events or complications. Conclusion: The Medineering Robotic Endoscope Guiding System seems to be a safe and effective support in endoscopic skull base surgery especially for orbital decompression, thus allowing 2-hand or even 4-hand settings. To the best of our knowledge, this is the first study describing the successful application of a robotic system in orbital surgery.

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“…Of course, the relevant synechia formation rate of 68% remained, which was mainly observed between the middle/upper turbinate and the septum. In a retrospective study, Schlüter et al recommended septal splints to reduce postoperative synechiae formation and associated odor and breathing impairment [ 47 ]. Since our patients did not subjectively perceive any restrictions despite synechiae, we still see no reason to routinely use prophylactic septum foils.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic trans-sphenoidal pituitary surgery does not impact postoperative nasal quality of life

Weiland,

Gellner,

Pondorfer

et al. 2023

Eur Arch Otorhinolaryngol

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Purpose The aim of this prospective longitudinal study was to assess both subjective quality of life using questionnaires and objective examination of nasal function with regard to olfaction, nasal air flow and mucociliary clearance in patients after minimally invasive, turbinate-preserving endoscopic transnasal trans-sphenoidal pituitary surgery. Methods Patients undergoing endoscopic transnasal pituitary surgery were recruited prospectively and examined during three study visits, preoperatively and 3 and 6 months postoperatively. We examined nasal function using sniffin' sticks test, rhinomanometry, saccharin transit time test, and endoscopic and radiological scores. In addition, the influence on subjective quality of life and mental health was recorded using the Sinonasal-Outcome-Test-20 (SNOT-20) and the Hospital-Anxiety-and-Depression-Scale (HADS). Results 20 patients undergoing endoscopic pituitary tumor resections were included. No significant changes in olfaction or mucociliary clearance were noted. Nasal air flow showed a tendency to increase in the postoperative course lacking significance. Both the endoscopy and the radiological scores showed a significant deterioration, especially after 3 months, with a trend towards improvement over time. However, neither the SNOT-20 nor the HADS showed significant changes compared to baseline. Conclusions Our concept of minimally invasive endoscopic tumor resections on the pituitary gland with preservation of nasal turbinates shows low morbidity for the patient. Despite objectifiable surgery-associated changes in the nose, nasal physiology in terms of smell, airflow and mucociliary clearance can be preserved and the subjective quality of life of our patients remains stable.

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Evaluation of the application of rhino-septal splints in endoscopic transsphenoidal skull base surgery

Cited by 7 publications

References 17 publications

Olfactory outcomes after endoscopic skull base surgery: A systematic review and meta‐analysis

Olfactory outcomes after endoscopic skull base surgery: A systematic review and meta‐analysis

First Use of a New Robotic Endoscope Guiding System in Endoscopic Orbital Decompression

Endoscopic trans-sphenoidal pituitary surgery does not impact postoperative nasal quality of life

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